Walter Mangezi | University of Zimbabwe (original) (raw)
Papers by Walter Mangezi
Blood group antigens are inherited characteristics which are grouped into 15 systems based on gen... more Blood group antigens are inherited characteristics which are grouped into 15 systems based on genetic, structural, biochemical and serological or immunological characteristics. The exact role of the blood group antigens is not yet fully understood, but recent studies have indicated some relationships between some blood group antigens and certain diseases or successes in transplantations. Some haemolytic anaemia due to membrane disorders are directly associated with abnormal or absence of certain blood groups. Other blood groups have been implicated in mental health and bleeding challenges. ABO blood group antigens are ubiquitous and are found in all body tissues. A cross sectional study was carried out at the Annex Hospital to determine the distributions of the ABO blood groups in mental health patients for a period of six months. AB and B blood group frequencies increased to 11.1% and 27% compared to 3.7% and 19.2% in the general population respectively. A and O blood group frequen...
Additional file 2: Appendix B. Interview Guides.
Background There are substantial gaps in our knowledge regarding the aetiology of mental, neurolo... more Background There are substantial gaps in our knowledge regarding the aetiology of mental, neurological and substance use disorders in sub-Saharan Africa, and the cost-effectiveness and scalability of interventions to reduce the burden of these conditions on the continent. To address these gaps, international investment has focussed on building research capacity, including funding doctoral students in African countries, to support development of high quality, contextually relevant interventions. Absent, however, is an understanding of how capacity building feeds into research careers.Methods Within a broader mental health research capacity-building initiative (African Mental Health Research Initiative), we conducted 52 qualitative interviews with early-career researchers, policymakers, academics, and service users from four African countries (Ethiopia, Malawi, South Africa, and Zimbabwe) and with international funders of mental health research. The interview guide focused on the rese...
Title: Depression among HIV positive pregnant women in Zimbabwe: a primary health care based cros... more Title: Depression among HIV positive pregnant women in Zimbabwe: a primary health care based cross-sectional study Authors: Eugenia Nyamukoho (eugenianyamukoho@yahoo.com) Walter Mangezi (wmangezi@yahoo.co.uk) Bazondlile Dube (bazoedube@gmail.com) Ruth Verhey (ruth.verhey@zol.co.zw) Dixon Chibanda (dichi@zol.co.zw) Version: 1 Date: 15 Dec 2018 Author’s response to reviews: The Editor BMC Pregnancy and childbirth RE: Revision-Depression among HIV positive pregnant women in Zimbabwe
In the practice of forensic psychiatry in Zimbabwe, there have been problems in bringing psychiat... more In the practice of forensic psychiatry in Zimbabwe, there have been problems in bringing psychiatric offenders to justice due to delays in assessment. This has been caused by a shortage of psychiatrists with the relevant skills. Practitioners need to be equipped with the required competencies to deal with both the civil and criminal domains of forensic psychiatry. They also need neuropsychological tools for the evaluation of offenders and victims, and knowledge of the appropriate tests to be used in each case. To date, the Department of Psychiatry at the University of Zimbabwe has had no formal curriculum in forensic psychiatry. To meet these needs, a forensic psychiatry curriculum was developed. The goals for the curriculum were for the students to: 1) acquire knowledge in the assessment and management of psychiatric conditions and their relation to criminal and civil legal issues; 2) attain attitudes that foster a focus on assessment of the patients’ mental health, not their innoc...
Additional file 1: Appendix A. Background to the four institutions supported by AMARI.
International Psychiatry, Oct 1, 2010
Zimbabwe is a landlocked country which has recently emerged from some marked political and socioe... more Zimbabwe is a landlocked country which has recently emerged from some marked political and socioeconomic challenges. Against this background, mental health has fallen down the priority list, as matters such as food shortages and the AIDS scourge have taken precedence. Zimbabwe is in southern Africa; Zambia and Botswana lie to the north, Namibia to the west, South Africa to the south and Mozambique to the east. Its population is 11.4 million. The capital city is Harare, which has a population of 1.6 million.
Wellcome Open Research, 2021
Background: Mental health is slowly gaining global significance as a key health issue, yet the st... more Background: Mental health is slowly gaining global significance as a key health issue, yet the stigma attached to psychosis is still a major problem. There has been little in-depth exploration of sustainable, cost-effective, and replicable community engagement strategies that address mental health myths and stigma, which are major barriers to early health-seeking behaviours. In low-income countries such as Zimbabwe, cultural and spiritual beliefs are at the centre of most mental health explanatory models, perpetuating an environment where mental health conversations are a cultural taboo. Mental health interventions should be accompanied by creative, evidence-based community engagement, ensuring that interventions are suitable for local settings and giving communities a voice in directing their health initiatives. Methods: Z Factor aimed to engage young adults and their support networks across a variety of socioeconomic groups in a rural district of Zimbabwe through their participat...
Annals of Global Health, 2020
The lancet. Psychiatry, 2021
The African Journal of Pharmacology and Therapeutics, 2015
Background: Tardive dyskinesia is a debilitating, intractable, hyperkinetic movement disorder whi... more Background: Tardive dyskinesia is a debilitating, intractable, hyperkinetic movement disorder which contributes to an increase in psychiatric morbidity. Reduced function CYP2D6 alleles have been associated with tardive dyskinesia pathogenesis amongst Caucasians and Asians, with CYP2D*4 and *6 and CYP2D6*10 being implicated in these races respectively. No similar study has been successfully conducted in black Africans. Objective: To determine the relationship between tardive dyskinesia and CYP2D6*17 (the major reduced function CYP2D6 allele in Africans). Methodology: Abnormal Involuntary Movements Scale (AIMS) scoring and CYP2D6 genotyping were carried out on psychiatric patients exposed to typical antipsychotic medications in an unmatched case control study. A case of tardive dyskinesia was defined as a patient with an AIMS score ≥ 2 in two body areas OR ≥ 3 in one body area Results: A total of 18 cases and 32 controls made up the study sample.The sample’s mean age was 36.9±12.0 yea...
Using a pilot trial design in an HIV care clinic in Zimbabwe, we randomised 32 adults with poor a... more Using a pilot trial design in an HIV care clinic in Zimbabwe, we randomised 32 adults with poor adherence to antiretroviral therapy and at least mild depression to either six sessions of Problem-Solving Therapy for adherence and depression (PST-AD) delivered by an adherence counsellor, or to Enhanced Usual Care (Control). Acceptability of PST-AD was high, as indicated by frequency of session attendance and through qualitative analyses of exit interviews. Fidelity was[80% for the first two sessions of PST-AD but fidelity to the adherence component of PST-AD dropped by session 4. Contamination occurred, in that seven patients in the control arm received one or two PST-AD sessions before follow-up assessment. Routine health records proved unreliable for measuring HIV viral load at follow-up. Barriers to measuring adherence electronically included device failure and participant perception of being helped by the research device. The study was not powered to detect clinical differences, h...
Archives of Women's Mental Health, 2009
Despite the significant burden of common mental disorders (CMD) among women in sub Saharan Africa... more Despite the significant burden of common mental disorders (CMD) among women in sub Saharan Africa, data on postnatal depression (PND) is very limited, especially in settings with a high HIV prevalence. The Edinburgh Postnatal Depression Scale (EPDS), a widely used screening test for PND has been validated in many countries, but not in Zimbabwe. We assessed the validity of the EPDS scale among postpartum women compared with Diagnostic Manual of Mental Disorders (DSM-IV) criteria for major depression. Six trained community counselors administered the Shona version of the EPDS to a random sample of 210 postpartum HIV-infected and uninfected women attending two primary care clinics in Chitungwiza. All women were subsequently subjected to mental status examination using DSM IV criteria for major depression by 2 psychiatrists, who were blinded to the subject’s EPDS scores. Data were analyzed using receiver operating characteristic (ROC) curve analysis. Of the 210 postpartum mothers enroll...
BJPsych International, 2021
This report describes a pilot project which involved undergraduate medical students’ clinical com... more This report describes a pilot project which involved undergraduate medical students’ clinical competence in psychiatry assessed through objective structured clinical examinations for the first time in Zimbabwe. The pilot describes how gaps in medical education can be addressed by collaborative partnerships that allow sharing of knowledge by local institutions and international experts.
The Lancet Psychiatry, 2020
Global Mental Health, 2020
Mental, neurological and substance use (MNS) disorders are a leading, but neglected, cause of mor... more Mental, neurological and substance use (MNS) disorders are a leading, but neglected, cause of morbidity and mortality in sub-Saharan Africa. The treatment gap for MNS is vast with only 10% of people with MNS disorders in low-income countries accessing evidence-based treatments. Reasons for this include low awareness of the burden of MNS disorders and limited evidence to support development, adaptation and implementation of effective and feasible treatments. The overall goal of the African Mental Health Research Initiative (AMARI) is to build an African-led network of MNS researchers in Ethiopia, Malawi, South Africa and Zimbabwe, who are equipped to lead high quality mental health research programs that meet the needs of their countries, and to establish a sustainable career pipeline for these researchers with an emphasis on integrating MNS research into existing programs such as HIV/AIDS. This paper describes the process leading to the development of AMARI's objectives through ...
The Lancet Psychiatry, 2020
The Lancet Global Health, 2020
AIDS and Behavior, 2019
Determination of HIV prevalence among people with mental illness is necessary for developing inte... more Determination of HIV prevalence among people with mental illness is necessary for developing integrated services for HIV and mental illness. This study determined HIV prevalence and uptake of HIV care among outpatients of psychiatric hospitals in Harare, Zimbabwe. HIV status was determined using open testing of 270 randomly selected consenting adult outpatients. HIV prevalence was 14.4% and the risk of acquiring HIV was similar to the general population of adults in Zimbabwe. Females were six times more likely to have HIV infection than males. Although a relatively high proportion of patients had been tested for HIV in the past (77.2%), fewer were recently tested (27.8%). Access to HIV care was high (94%) amongst patients previously diagnosed to be HIV positive. Tertiary mental health services should offer similar HIV care packages as other points of care and there is need for interventions that reduce the risk of HIV in women with mental disorders.
International Psychiatry, 2010
Zimbabwe is a landlocked country which has recently emerged from some marked political and socio-... more Zimbabwe is a landlocked country which has recently emerged from some marked political and socio-economic challenges. Against this background, mental health has fallen down the priority list, as matters such as food shortages and the AIDS scourge have taken prece dence. Zimbabwe is in southern Africa; Zambia and Botswana lie to the north, Namibia to the west, South Africa to the south and Mozambique to the east. Its population is 11.4 million. The capital city is Harare, which has a population of 1.6 million.
Blood group antigens are inherited characteristics which are grouped into 15 systems based on gen... more Blood group antigens are inherited characteristics which are grouped into 15 systems based on genetic, structural, biochemical and serological or immunological characteristics. The exact role of the blood group antigens is not yet fully understood, but recent studies have indicated some relationships between some blood group antigens and certain diseases or successes in transplantations. Some haemolytic anaemia due to membrane disorders are directly associated with abnormal or absence of certain blood groups. Other blood groups have been implicated in mental health and bleeding challenges. ABO blood group antigens are ubiquitous and are found in all body tissues. A cross sectional study was carried out at the Annex Hospital to determine the distributions of the ABO blood groups in mental health patients for a period of six months. AB and B blood group frequencies increased to 11.1% and 27% compared to 3.7% and 19.2% in the general population respectively. A and O blood group frequen...
Additional file 2: Appendix B. Interview Guides.
Background There are substantial gaps in our knowledge regarding the aetiology of mental, neurolo... more Background There are substantial gaps in our knowledge regarding the aetiology of mental, neurological and substance use disorders in sub-Saharan Africa, and the cost-effectiveness and scalability of interventions to reduce the burden of these conditions on the continent. To address these gaps, international investment has focussed on building research capacity, including funding doctoral students in African countries, to support development of high quality, contextually relevant interventions. Absent, however, is an understanding of how capacity building feeds into research careers.Methods Within a broader mental health research capacity-building initiative (African Mental Health Research Initiative), we conducted 52 qualitative interviews with early-career researchers, policymakers, academics, and service users from four African countries (Ethiopia, Malawi, South Africa, and Zimbabwe) and with international funders of mental health research. The interview guide focused on the rese...
Title: Depression among HIV positive pregnant women in Zimbabwe: a primary health care based cros... more Title: Depression among HIV positive pregnant women in Zimbabwe: a primary health care based cross-sectional study Authors: Eugenia Nyamukoho (eugenianyamukoho@yahoo.com) Walter Mangezi (wmangezi@yahoo.co.uk) Bazondlile Dube (bazoedube@gmail.com) Ruth Verhey (ruth.verhey@zol.co.zw) Dixon Chibanda (dichi@zol.co.zw) Version: 1 Date: 15 Dec 2018 Author’s response to reviews: The Editor BMC Pregnancy and childbirth RE: Revision-Depression among HIV positive pregnant women in Zimbabwe
In the practice of forensic psychiatry in Zimbabwe, there have been problems in bringing psychiat... more In the practice of forensic psychiatry in Zimbabwe, there have been problems in bringing psychiatric offenders to justice due to delays in assessment. This has been caused by a shortage of psychiatrists with the relevant skills. Practitioners need to be equipped with the required competencies to deal with both the civil and criminal domains of forensic psychiatry. They also need neuropsychological tools for the evaluation of offenders and victims, and knowledge of the appropriate tests to be used in each case. To date, the Department of Psychiatry at the University of Zimbabwe has had no formal curriculum in forensic psychiatry. To meet these needs, a forensic psychiatry curriculum was developed. The goals for the curriculum were for the students to: 1) acquire knowledge in the assessment and management of psychiatric conditions and their relation to criminal and civil legal issues; 2) attain attitudes that foster a focus on assessment of the patients’ mental health, not their innoc...
Additional file 1: Appendix A. Background to the four institutions supported by AMARI.
International Psychiatry, Oct 1, 2010
Zimbabwe is a landlocked country which has recently emerged from some marked political and socioe... more Zimbabwe is a landlocked country which has recently emerged from some marked political and socioeconomic challenges. Against this background, mental health has fallen down the priority list, as matters such as food shortages and the AIDS scourge have taken precedence. Zimbabwe is in southern Africa; Zambia and Botswana lie to the north, Namibia to the west, South Africa to the south and Mozambique to the east. Its population is 11.4 million. The capital city is Harare, which has a population of 1.6 million.
Wellcome Open Research, 2021
Background: Mental health is slowly gaining global significance as a key health issue, yet the st... more Background: Mental health is slowly gaining global significance as a key health issue, yet the stigma attached to psychosis is still a major problem. There has been little in-depth exploration of sustainable, cost-effective, and replicable community engagement strategies that address mental health myths and stigma, which are major barriers to early health-seeking behaviours. In low-income countries such as Zimbabwe, cultural and spiritual beliefs are at the centre of most mental health explanatory models, perpetuating an environment where mental health conversations are a cultural taboo. Mental health interventions should be accompanied by creative, evidence-based community engagement, ensuring that interventions are suitable for local settings and giving communities a voice in directing their health initiatives. Methods: Z Factor aimed to engage young adults and their support networks across a variety of socioeconomic groups in a rural district of Zimbabwe through their participat...
Annals of Global Health, 2020
The lancet. Psychiatry, 2021
The African Journal of Pharmacology and Therapeutics, 2015
Background: Tardive dyskinesia is a debilitating, intractable, hyperkinetic movement disorder whi... more Background: Tardive dyskinesia is a debilitating, intractable, hyperkinetic movement disorder which contributes to an increase in psychiatric morbidity. Reduced function CYP2D6 alleles have been associated with tardive dyskinesia pathogenesis amongst Caucasians and Asians, with CYP2D*4 and *6 and CYP2D6*10 being implicated in these races respectively. No similar study has been successfully conducted in black Africans. Objective: To determine the relationship between tardive dyskinesia and CYP2D6*17 (the major reduced function CYP2D6 allele in Africans). Methodology: Abnormal Involuntary Movements Scale (AIMS) scoring and CYP2D6 genotyping were carried out on psychiatric patients exposed to typical antipsychotic medications in an unmatched case control study. A case of tardive dyskinesia was defined as a patient with an AIMS score ≥ 2 in two body areas OR ≥ 3 in one body area Results: A total of 18 cases and 32 controls made up the study sample.The sample’s mean age was 36.9±12.0 yea...
Using a pilot trial design in an HIV care clinic in Zimbabwe, we randomised 32 adults with poor a... more Using a pilot trial design in an HIV care clinic in Zimbabwe, we randomised 32 adults with poor adherence to antiretroviral therapy and at least mild depression to either six sessions of Problem-Solving Therapy for adherence and depression (PST-AD) delivered by an adherence counsellor, or to Enhanced Usual Care (Control). Acceptability of PST-AD was high, as indicated by frequency of session attendance and through qualitative analyses of exit interviews. Fidelity was[80% for the first two sessions of PST-AD but fidelity to the adherence component of PST-AD dropped by session 4. Contamination occurred, in that seven patients in the control arm received one or two PST-AD sessions before follow-up assessment. Routine health records proved unreliable for measuring HIV viral load at follow-up. Barriers to measuring adherence electronically included device failure and participant perception of being helped by the research device. The study was not powered to detect clinical differences, h...
Archives of Women's Mental Health, 2009
Despite the significant burden of common mental disorders (CMD) among women in sub Saharan Africa... more Despite the significant burden of common mental disorders (CMD) among women in sub Saharan Africa, data on postnatal depression (PND) is very limited, especially in settings with a high HIV prevalence. The Edinburgh Postnatal Depression Scale (EPDS), a widely used screening test for PND has been validated in many countries, but not in Zimbabwe. We assessed the validity of the EPDS scale among postpartum women compared with Diagnostic Manual of Mental Disorders (DSM-IV) criteria for major depression. Six trained community counselors administered the Shona version of the EPDS to a random sample of 210 postpartum HIV-infected and uninfected women attending two primary care clinics in Chitungwiza. All women were subsequently subjected to mental status examination using DSM IV criteria for major depression by 2 psychiatrists, who were blinded to the subject’s EPDS scores. Data were analyzed using receiver operating characteristic (ROC) curve analysis. Of the 210 postpartum mothers enroll...
BJPsych International, 2021
This report describes a pilot project which involved undergraduate medical students’ clinical com... more This report describes a pilot project which involved undergraduate medical students’ clinical competence in psychiatry assessed through objective structured clinical examinations for the first time in Zimbabwe. The pilot describes how gaps in medical education can be addressed by collaborative partnerships that allow sharing of knowledge by local institutions and international experts.
The Lancet Psychiatry, 2020
Global Mental Health, 2020
Mental, neurological and substance use (MNS) disorders are a leading, but neglected, cause of mor... more Mental, neurological and substance use (MNS) disorders are a leading, but neglected, cause of morbidity and mortality in sub-Saharan Africa. The treatment gap for MNS is vast with only 10% of people with MNS disorders in low-income countries accessing evidence-based treatments. Reasons for this include low awareness of the burden of MNS disorders and limited evidence to support development, adaptation and implementation of effective and feasible treatments. The overall goal of the African Mental Health Research Initiative (AMARI) is to build an African-led network of MNS researchers in Ethiopia, Malawi, South Africa and Zimbabwe, who are equipped to lead high quality mental health research programs that meet the needs of their countries, and to establish a sustainable career pipeline for these researchers with an emphasis on integrating MNS research into existing programs such as HIV/AIDS. This paper describes the process leading to the development of AMARI's objectives through ...
The Lancet Psychiatry, 2020
The Lancet Global Health, 2020
AIDS and Behavior, 2019
Determination of HIV prevalence among people with mental illness is necessary for developing inte... more Determination of HIV prevalence among people with mental illness is necessary for developing integrated services for HIV and mental illness. This study determined HIV prevalence and uptake of HIV care among outpatients of psychiatric hospitals in Harare, Zimbabwe. HIV status was determined using open testing of 270 randomly selected consenting adult outpatients. HIV prevalence was 14.4% and the risk of acquiring HIV was similar to the general population of adults in Zimbabwe. Females were six times more likely to have HIV infection than males. Although a relatively high proportion of patients had been tested for HIV in the past (77.2%), fewer were recently tested (27.8%). Access to HIV care was high (94%) amongst patients previously diagnosed to be HIV positive. Tertiary mental health services should offer similar HIV care packages as other points of care and there is need for interventions that reduce the risk of HIV in women with mental disorders.
International Psychiatry, 2010
Zimbabwe is a landlocked country which has recently emerged from some marked political and socio-... more Zimbabwe is a landlocked country which has recently emerged from some marked political and socio-economic challenges. Against this background, mental health has fallen down the priority list, as matters such as food shortages and the AIDS scourge have taken prece dence. Zimbabwe is in southern Africa; Zambia and Botswana lie to the north, Namibia to the west, South Africa to the south and Mozambique to the east. Its population is 11.4 million. The capital city is Harare, which has a population of 1.6 million.